Herceptin is a monoclonal antibody that is used for the treatment of breast cancer. It is also prescribed for treatment of stomach cancer. Herceptin is only recommended for patients whose cancers are HER2-positive, characterized by the growth of the protein called human epidermal growth factor receptor. According to experts, 1 out of 5 cases of stomach and breast cancer are HER2-positive.
It is used during the early stages of breast cancer to complement surgery and chemotherapy and decrease the chances of the cancer growing again. The drug is also recommended for advanced stages of breast cancer and stomach cancer, wherein the tumors have spread out of the stomach. It should be noted that this drug does not cure breast and stomach cancer but only slows down the growth of the tumors and increases the survival chances of the patient.
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Herceptin is administered intravenously, usually once a week for patients with breast cancer and once every three weeks for those with stomach cancer. The first session of administering the drug is usually longer as doctors will have to monitor the patient’s reaction to the medication. The dose, speed of injection and amount of time that the medication is administered will depend on the condition, body weight and response to treatment of the patient.
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Cancer patients who are given Herceptin may notice side effects like diarrhea, muscle or joint pain, uncontrollable shaking and trembling, redness and itchiness of the front of the eyes and changes in blood pressure. Some may also experience flu-like symptoms like headache, chills and high temperature as well as irregular heartbeat, coughing, difficulty in breathing, nosebleeds and abdominal pain.
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Normally, these side effects appear immediately after the patient has been infused with the drug. These should become less frequent and milder after the patient’s body gets accustomed to the medication. Side effects are said to occur in 1 out of 10 patients administered with Herceptin.
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Warnings/Precautions:
Increased risk of cardiomyopathy. Conduct cardiac assessment (eg, history, physical exam, LVEF) at baseline, every 3 months during and after therapy or every 6 months for ≥2yrs after therapy (if adjuvant); repeat LVEF at 4 week intervals if dose is withheld due to significant left ventricular cardiac dysfunction. Interrupt therapy if dyspnea or significant hypotension occurs; consider discontinuing permanently if severe infusion reactions, CHF, pulmonary toxicity, or significant left ventricular myocardial dysfunction develops. Symptomatic intrinsic lung disease. Extensive tumor involvement of the lungs. Test for HER2 protein overexpression and HER2 gene amplification using FDA-approved tests for specific tumor type (breast or gastric/gastroesophageal adenocarcinoma). Embryo-fetal toxicity (eg, oligohydramnios): exclude pregnancy status before initiation. Pregnancy: avoid; use effective contraception during and for 7 months after therapy. Nursing mothers.
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Interactions
Herceptin should not be used with the following drugs:
Sipuleucel-t
Beclomethasone
Paclitaxel
Denosumab
Fingolimod
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Adverse Reactions:
Fever, diarrhea, nausea, chills, infections, increased cough, headache, CHF, insomnia, fatigue, dyspnea, rash, neutropenia, anemia, thrombocytopenia, stomatitis, mucosal inflammation, weight loss, nasopharyngitis, dysgeusia, myalgia, thrombosis/embolism; severe infusion reactions, febrile neutropenia/exacerbation of chemotherapy-induced neutropenia, pulmonary toxicity (eg, interstitial pneumonitis), cardiomyopathy (eg, left ventricular myocardial dysfunction).
